Faculty Bibliography

Thyroid hormone receptors (TRs), expressed as TRalpha1, TRbeta1, and TRbeta2 isoforms, are members of the steroid hormone nuclear receptor gene superfamily, which comprises ligand-dependent transcription factors. The TR isoforms differ primarily in their N-terminal (A/B) domains, suggesting that the A/B regions mediate distinct transcriptional activation functions in a cell type-dependent or promoter-specific fashion. The nuclear receptor ligand-binding domain (LBD) undergoes a conformational change upon ligand binding that results in the recruitment of coactivators to the LBD. For glucocorticoid receptor and estrogen receptor-alpha, the same coactivator can contact both the LBD and A/B domains, thus leading to enhanced transcriptional activation. Very little is known regarding the role of the A/B domains of the TR isoforms. The A/B domain of TRbeta2 exhibits higher ligand-independent transcriptional activity than the A/B regions of TRalpha1 or TRbeta1. Thus, we examined the role of the A/B domain and the LBD of rat TRbeta2 in integrating the transcriptional activation function of the A/B and LBD domains by different coactivators. Both domains are essential for a productive functional interaction with cAMP response element-binding protein (CREB)-binding protein (CBP), and we found that CBP binds to the A/B domain of TRbeta2 in vitro. In contrast, steroid receptor coactivator-1a (SRC-1a) interacts strongly with the LBD but not the A/B domain. The coactivator NRC (nuclear receptor coactivator) interacts primarily with the LBD, although a weak interaction with the A/B domain further enhances ligand-dependent binding with TRbeta2. Our studies document the interplay between the A/B domain and the LBD of TRbeta2 in recruiting different coactivators to the receptor. Because NRC and SRC-1a bind CBP, and CBP enhances ligand-dependent activity, our studies suggest a model in which coactivator recruitment of NRC (or SRC-1a) occurs primarily through the LBD whereas the complex is further stabilized through an interaction of CBP with the N terminus of TRbeta2

Measles is preventable: 99% of those who receive the two-step vaccination develop immunity. The measles vaccine uses a live attenuated virus, which means a deactivated virus that can still provoke immunity but no longer get people sick. There is a growing irrational fear of vaccinations that is not connected to fact. This fear leads to disuse of a crucial preventative. While it is understandable that parents are concerned about vaccines their child receives, the measles vaccine requires 100% compliance to effectively prevent reoccurrence and control spread of a deadly disease

Chronic disease management is becoming increasingly important in correctional settings, especially diabetes. We conducted a retrospective chart review of diabetic inmates in San Francisco County Jail and examined the sociodemographic characteristics, markers of disease status, and compliance with jail-specific care guidelines within this setting. We found high rates of compliance with immediate-term care guidelines (e.g., finger-stick glucose and blood pressure checks at intake) but less success in providing the more complex care required for chronic diseases. Inmates' age, race, and gender did not affect likelihood of meeting guidelines

BACKGROUND: We studied female graduates of the Robert Wood Johnson Clinical Scholars Program (CSP, Class of 1984 to 1989) to explore and describe the complexity of creating balance in the life of mid-career academic woman physicians. METHODS: We conducted and qualitatively analyzed (kappa 0.35 to 1.0 for theme identification among rater pairs) data from a semi-structured survey of 21 women and obtained their curricula vitae to quantify publications and grant support, measures of academic productivity. RESULTS: Sixteen of 21 (76%) women completed the survey. Mean age was 48 (range: 45 to 56). Three were full professors, 10 were associate professors, and 3 had left academic medicine. Eleven women had had children (mean 2.4; range: 1 to 3) and 3 worked part-time. From these data, the conceptual model expands on 3 key themes: (1) defining, navigating, and negotiating success, (2) making life work, and (3) making work work. The women who described themselves as satisfied with their careers (10/16) had clarity of values and goals and a sense of control over their time. Those less satisfied with their careers (6/16) emphasized the personal and professional costs of the struggle to balance their lives and described explicit institutional barriers to fulfillment of their potential. CONCLUSION: For this group of fellowship-prepared academic women physicians satisfaction is achieving professional and personal balance

BACKGROUND:High-dose clenbuterol (a selective beta2-adrenergic agonist) has been proposed to promote myocardial recovery during left ventricular assist device (LVAD) support, but its effects on cardiac and skeletal muscle are largely unknown. METHODS:Seven subjects with heart failure (5 ischemic, 2 non-ischemic) were started on oral clenbuterol 5 to 46 weeks post-LVAD implantation and up-titrated to daily doses of 720 microg. The following procedures were performed at baseline and after 3 months of therapy: echocardiography at reduced support (4 liters/min); cardiopulmonary exercise testing; body composition analysis; and quadriceps maximal voluntary contraction (MVC). Myocardial histologic analysis was measured at device implantation and explantation. RESULTS:There were no serious adverse events or arrhythmias. Creatine phosphokinase (CPK) was elevated in 4 subjects, with no clinical sequelae. No change in ejection fraction was seen. End-diastolic dimension increased significantly (4.73 +/- 0.67 vs 5.24 +/- 0.66; p < 0.01), despite a trend toward increased LV mass. Body weight and lean mass increased significantly (75.5 +/- 17.9 vs 79.2 +/- 25.1 kg, 21.1 +/- 8.9 vs 23.6 +/- 9.7 kg, respectively; both p < 0.05). Exercise capacity did not change, but MVC improved significantly from 37.0 +/- 15.7 to 45.8 +/- 20.6 kg (p < 0.05). No significant change in myocyte size or collagen deposition was seen. CONCLUSIONS:Cardiac function did not improve in this cohort of LVAD patients treated with high-dose clenbuterol. However, clenbuterol therapy increased skeletal muscle mass and strength and prevented the expected decrease in myocyte size during LVAD support. Further study will clarify its potential for cardiac and skeletal muscle recovery.

Weeds [Television Program] -- NANCY BOTWIN (Mary-Louise Parker) is struggling to bring up her two sons and maintain the same lifestyle in the wake of her husband's sudden death. She secretly becomes a local pot dealer. Meanwhile, her family's life deteriorates. While Nancy is on a romantic tryst, her older son, 16-year-old Silas (Hunter Parrish), has his girlfriend stay over, and 10-year-old brother Shane (Alexander Gould) observes them having sex. Nancy's pot supplier Heylia (Tonye Patano), mother to a large brood of her own, suggests that family dinners are the 'superglue' that holds families together, and that studies have shown children do better in the long term, with higher test scores and less depression, when families eat together regularly. 'IT'S terrible to wake up in the middle of the night and not know where your mom is,' says Irene Goldenberg, family therapist and professor emeritus of psychiatry at UCLA. In her opinion, a bigger problem than the fact that Nancy isn't home much is that she is lying to her kids about her actions and whereabouts

South Africa has the largest number of H.I.V.-infected people in the world. Its president, Thabo Mbeki, has continually expressed skepticism that H.I.V. causes AIDS, and the country has questioned antiretroviral treatment and delayed providing it to pregnant women and AIDS patients. Other speakers urged training more nurses and health workers in poor countries to deliver the antiretroviral drugs and preventive measures needed to stop the AIDS epidemic. The many international programs that are scaling up efforts to deliver antiretroviral drugs to poor people cannot succeed without large numbers of health workers to monitor the care of AIDS patients. As the conference speakers delivered their remarks, hundreds of Africans, Asians and people from around the world began dismantling the global village created here to promote discussion of H.I.V. One exhibit, called ''Dress Up Against AIDS,'' included 10 dresses by Adriana Bertini, a Brazilian artist, made from thousands of condoms. Nearby were women from the Masaka district of Uganda who displayed their crafts, including mats, straw bowls and drums. In another booth, Kenyan workers showed off sandals and beaded necklaces. In others, attendants handed out pamphlets on programs for H.I.V. and AIDS